Sempere G A Javier, Martinez Sanjuan Vicente, Medina Chulia Enrique, Benages Adolfo, Tome Toyosato Alicia, Canelles Pilar, Bulto Antonio, Quiles Francisco, Puchades Iciar, Cuquerella Jaime, Celma Julian, Orti Elisa
Servicio Patologia Digestiva, Hospital General Universitario de Valencia, Valencia, Spain.
AJR Am J Roentgenol. 2005 Jun;184(6):1829-35. doi: 10.2214/ajr.184.6.01841829.
We wanted to assess the capability of MRI to quantitatively evaluate the therapeutic response to Crohn's disease (CD) relapse.
Twenty patients with histologically proven CD were prospectively evaluated with MRI and ileocolonoscopy over a 2-year period. The MRI protocol included axial and coronal T2-weighted and contrast-enhanced T1-weighted sequences. MRI examinations were performed twice, once during an acute relapse of CD and the other at clinical remission. The terminal ileum and colon were divided into six segments/patient, and the endoscopy and histology findings were considered the standard of reference. These were compared on a segmental basis with the quantitative MRI findings regarding wall thickness and contrast enhancement. The results obtained in active and remission CD phases were likewise compared with the findings in 10 control subjects who underwent complete ileocolonoscopy for other reasons and had no pathological findings on ileocolonoscopy.
Fifty three of 120 (44.2%) bowel segments showed pathologic changes on endoscopy and histology consistent with CD in active phase. On changing from the active disease phase to clinical remission, a significant decrease was observed in the wall thickness and contrast enhancement of the affected bowel wall. In the active phase of CD, the pathologic bowel segments presented with significantly greater contrast enhancement and wall thickness values compared with the healthy segments of CD and controls. On converting clinically into remission, contrast enhancement tended to normalize, whereas bowel wall thickness remained increased compared with the controls.
MRI is able to detect pathologic bowel segments in CD, as it allows the measurement of significant variations in wall thickness and contrast enhancement on changing from the active phase of the disease to remission.
我们旨在评估磁共振成像（MRI）定量评估克罗恩病（CD）复发治疗反应的能力。
20例经组织学证实为CD的患者在2年期间接受了MRI和回结肠镜检查的前瞻性评估。MRI方案包括轴位和冠状位T2加权及对比增强T1加权序列。MRI检查进行了两次，一次在CD急性复发期间，另一次在临床缓解期。将末段回肠和结肠分为六个节段/患者，内镜和组织学检查结果被视为参考标准。将这些结果与关于肠壁厚度和对比增强的定量MRI结果进行节段性比较。同样将活动期和缓解期CD阶段获得的结果与10名因其他原因接受全回结肠镜检查且回结肠镜检查无病理发现的对照受试者的结果进行比较。
120个肠段中的53个（44.2%）在内镜和组织学检查中显示出与活动期CD一致的病理变化。从疾病活动期转变为临床缓解期时，观察到受累肠壁的厚度和对比增强显著降低。在CD活动期，与CD健康节段和对照相比，病理肠段的对比增强和肠壁厚度值显著更高。临床转为缓解期时，对比增强趋于正常化，而与对照相比肠壁厚度仍增加。
MRI能够检测CD中的病理肠段，因为它可以测量从疾病活动期到缓解期时肠壁厚度和对比增强的显著变化。
